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Don't assume a dab of IT training will not turn a clinician into a PMO

Posted Aug 18 2010 2:53pm

Like you, I see two distinct groups who do not play well in the same sandbox-clinical and IT.

Sometimes one group will try to quickly learn skills from the other group.

But having members of one group go to the other's summer camp to pick up a few skills will not qualify them to pull a few costly and hairy projects from the bowels of project hell any more than having an IT executive take an EMT course would qualify that person to perform surgery. Studying anything for a brief period does not mean you're qualified to perform that task.

Before I get up off my stool and knock myself out, I know CMIOs and CIOs who have made HIT and EHR very successful. To them I say, do not rake me across the Twitter coals as I try to make a point.

There's knowledge, and then there's qualified knowledge. Doctors do four years of medical school, they intern, and if they specialize, they throw in a few more years before they become the in-charge. There are years of training and practice before the doctor is allowed to run the show.

Why? Because what they are about to undertake requires practice, tutelage, and expertise. Most of the actual learning occurs outside the classroom.

There are those who suggest that the skills needed to manage successfully something as foreboding as full-blown EHR can be picked up at IT Camp. They do a disservice to seasoned IT professionals.

Most large IT projects fail. I believe large EHR projects will fail at an even higher rate. Most clinical procedures do not fail, even the risky ones. What's the spin line from this discussion?

Rule 1: Large EHR projects will fail at an alarming rate.
Rule 2: Sending a doctor to band camp probably won't change Rule 1.

Don't believe me? Ask your friends in other industries how their implementation of an Enterprise Resource Planning system or manufacturing system went. There are consulting firms that make a bundle doing disaster recovery work on failed IT projects. They circle the halls like turkey vultures waiting for CIO or project manager carrion.

Back to Rule 1 for a moment. How can I state that large EHR projects will fail at an alarming rate with such assurance? Never before in the history of before-I know that's not a proper phrase-has any single industry attempted to use IT to:

*impart such radical charge (patients, doctors, employees)
*impart it on a national basis
*hit moving and poorly defined targets-interoperability, meaningful use, certification
*take guidance from nobody (there is no EHR decider)
*implement a solution from among hundreds of vendors
*implement a solution with no standards
*move from an industry at 0.2 to 2.0 business practices
*concurrently reform the entire industry

Just what should a CMIO be able to do? What are the standards for a CMIO? To me, they vary widely.

Is a CMIO considered an officer in the same sense as the other "O's" in the organization, or is it simply a naming convention? The answer to that question probably depends on the provider.

Here's how I think it should work-I realize nobody has asked for my opinion, but this way I'll at least provide good fodder for those who are so bold as to disagree in writing.

I love the concept of the CMIO and think it is essential to move the provider's organization from the 0.2 model to the 2.0 model. Same with the CIO.

However, getting them to pool their efforts on something like EHR is likely to fail as soon as one is placed in a position of authority over the other. It's sort of like getting the Americans and French to like one another.

I liken the CMIO's value-add to that of the person providing the color commentary on ESPN-it adds meaning and relevancy. The CMIO owns and answers a lot of the "what" and the CIO owns and answers a lot of the "how."

Still unanswered are the "why" and "when." A skill is needed so that someone can state with assurance, "Follow me. Tomorrow we will do this because this is what needs to be done tomorrow." That skill comes from an experienced Project Management Officer, the PMO.

It does not come from someone who "we think can handle the job." Nobody will respect that person’s ability, and if they can't lead, you can plan on doing your project over.

Paul Roemer is a healthcare strategist and the managing partner of Healthcare IT Strategy , which helps health care providers solve business problems using EHR, workflow improvement, and change management.

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